DownloaD CertifieD PeDiatriC
Hematology onCology nurse (CPHon®)
exam: 100 PraCtiCe Questions witH
answers anD rationales alreaDy
graDeD a+
Below are 100 practice questions designed to reflect the content domains of the CPHON® exam
based on the official ONCC Test Content Outline. The questions cover the six major
domains: Care Continuum (6%), Pediatric Hematology and Oncology Nursing Practice (18%),
Treatment Modalities and Side Effects (21%), Symptom Management and Supportive Care
(26%), Pediatric Hematologic and Oncologic Emergencies (21%), and Psychosocial Dimensions
of Care (8%) . Answers and detailed rationales are provided for each question .
Domain 1: Care Continuum (6%)
1. A 16-year-old patient is completing active treatment for Hodgkin lymphoma. The nurse is
developing a survivorship care plan. Which of the following is the most important component
of this plan?
• A) A summary of the patient's treatment and recommendations for long-term follow-up
• B) A list of all medications the patient has ever taken
• C) A schedule for the patient's next hospitalization
• D) A referral to a genetic counselor
Answer: A) A summary of the patient's treatment and recommendations for long-term follow-
up
Rationale: Survivorship care plans are a key component of the care continuum and include a
,treatment summary and follow-up recommendations to monitor for late effects . This ensures
continuity of care as the patient transitions off active treatment .
2. A child with a newly diagnosed brain tumor is being discharged home after surgery. The
nurse should prioritize which transition of care activity?
• A) Arranging for the child to be seen by the primary care provider within 6 months
• B) Providing a clear discharge summary with medication instructions and follow-up
appointments
• C) Ensuring the child's school has a copy of the medical records
• D) Coordinating with the family's insurance company
Answer: B) Providing a clear discharge summary with medication instructions and follow-up
appointments
Rationale: Transitions of care in pediatric hematology/oncology require clear communication
between care settings, including a discharge summary with medication instructions and follow-
up appointments . This ensures patient safety during care transitions.
3. The nurse is preparing a patient for an end-of-life transition. Which of the following is an
appropriate nursing action?
• A) Focus exclusively on curative treatment options
• B) Avoid discussing death to prevent family distress
• C) Ensure that the patient's and family's goals are addressed and that comfort measures
are in place
• D) Recommend that the family wait until the patient is actively dying to initiate palliative
care
Answer: C) Ensure that the patient's and family's goals are addressed and that comfort
measures are in place
Rationale: End-of-life care is a component of the care continuum that focuses on ensuring that
the patient's and family's goals are addressed and that comfort measures are in place .
4. A 14-year-old patient with a history of cancer is returning to school. The nurse's role in
health promotion and maintenance includes:
• A) Advising the family to avoid discussing the cancer diagnosis with the school
, • B) Coordinating with the school to ensure the patient's educational and health needs are
met
• C) Recommending that the patient delay returning to school until treatment is
completed
• D) Informing the patient that they should not participate in physical education
Answer: B) Coordinating with the school to ensure the patient's educational and health needs
are met
Rationale: Health promotion and maintenance in the care continuum includes coordinating care
with the school to ensure the patient's educational and health needs are met .
Domain 2: Pediatric Hematology and Oncology Nursing Practice (18%)
5. A 6-year-old child is diagnosed with acute lymphoblastic leukemia (ALL). The nurse
understands that the most common presenting symptom of ALL is:
• A) Bone pain and fever
• B) Headache and vomiting
• C) Abdominal pain and constipation
• D) Skin rash and itching
Answer: A) Bone pain and fever
Rationale: Common presenting symptoms of ALL in children include bone pain, fever, fatigue,
easy bruising, and pallor due to bone marrow infiltration with leukemic cells .
6. Which of the following is the most common type of childhood cancer?
• A) Neuroblastoma
• B) Wilms tumor
• C) Acute lymphoblastic leukemia (ALL)
• D) Osteosarcoma
Answer: C) Acute lymphoblastic leukemia (ALL)
Rationale: ALL is the most common malignancy in children, accounting for approximately 25%
of all childhood cancers. It is a cancer of the blood and bone marrow characterized by the
overproduction of immature lymphocytes .
, 7. A child is diagnosed with sickle cell disease. The nurse's understanding of the
pathophysiology of this disorder is based on which of the following?
• A) A deficiency of red blood cells due to chronic bleeding
• B) A genetic mutation causing abnormal hemoglobin S, leading to sickling of red blood
cells
• C) An autoimmune disorder causing destruction of red blood cells
• D) A lack of clotting factors
Answer: B) A genetic mutation causing abnormal hemoglobin S, leading to sickling of red
blood cells
Rationale: Sickle cell disease is a genetic disorder caused by a mutation in the hemoglobin beta
gene, leading to the production of abnormal hemoglobin S. This causes red blood cells to
become sickle-shaped, leading to vaso-occlusion and hemolysis .
8. A nurse is reviewing the results of a bone marrow aspiration for a patient with leukemia.
The presence of which of the following would confirm the diagnosis?
• A) Decreased red blood cell count
• B) Presence of blasts (>20%)
• C) Elevated platelet count
• D) Increased mature lymphocytes
Answer: B) Presence of blasts (>20%)
Rationale: A bone marrow aspiration showing >20% blasts confirms the diagnosis of leukemia.
Other findings such as anemia and thrombocytopenia may be present but are not diagnostic on
their own .
9. A 3-year-old child is diagnosed with Wilms tumor. The nurse understands that the classic
presentation of this tumor includes:
• A) An abdominal mass that is often asymptomatic
• B) Severe headache and vomiting
• C) Bone pain and limping
• D) Unexplained fever and night sweats
Hematology onCology nurse (CPHon®)
exam: 100 PraCtiCe Questions witH
answers anD rationales alreaDy
graDeD a+
Below are 100 practice questions designed to reflect the content domains of the CPHON® exam
based on the official ONCC Test Content Outline. The questions cover the six major
domains: Care Continuum (6%), Pediatric Hematology and Oncology Nursing Practice (18%),
Treatment Modalities and Side Effects (21%), Symptom Management and Supportive Care
(26%), Pediatric Hematologic and Oncologic Emergencies (21%), and Psychosocial Dimensions
of Care (8%) . Answers and detailed rationales are provided for each question .
Domain 1: Care Continuum (6%)
1. A 16-year-old patient is completing active treatment for Hodgkin lymphoma. The nurse is
developing a survivorship care plan. Which of the following is the most important component
of this plan?
• A) A summary of the patient's treatment and recommendations for long-term follow-up
• B) A list of all medications the patient has ever taken
• C) A schedule for the patient's next hospitalization
• D) A referral to a genetic counselor
Answer: A) A summary of the patient's treatment and recommendations for long-term follow-
up
Rationale: Survivorship care plans are a key component of the care continuum and include a
,treatment summary and follow-up recommendations to monitor for late effects . This ensures
continuity of care as the patient transitions off active treatment .
2. A child with a newly diagnosed brain tumor is being discharged home after surgery. The
nurse should prioritize which transition of care activity?
• A) Arranging for the child to be seen by the primary care provider within 6 months
• B) Providing a clear discharge summary with medication instructions and follow-up
appointments
• C) Ensuring the child's school has a copy of the medical records
• D) Coordinating with the family's insurance company
Answer: B) Providing a clear discharge summary with medication instructions and follow-up
appointments
Rationale: Transitions of care in pediatric hematology/oncology require clear communication
between care settings, including a discharge summary with medication instructions and follow-
up appointments . This ensures patient safety during care transitions.
3. The nurse is preparing a patient for an end-of-life transition. Which of the following is an
appropriate nursing action?
• A) Focus exclusively on curative treatment options
• B) Avoid discussing death to prevent family distress
• C) Ensure that the patient's and family's goals are addressed and that comfort measures
are in place
• D) Recommend that the family wait until the patient is actively dying to initiate palliative
care
Answer: C) Ensure that the patient's and family's goals are addressed and that comfort
measures are in place
Rationale: End-of-life care is a component of the care continuum that focuses on ensuring that
the patient's and family's goals are addressed and that comfort measures are in place .
4. A 14-year-old patient with a history of cancer is returning to school. The nurse's role in
health promotion and maintenance includes:
• A) Advising the family to avoid discussing the cancer diagnosis with the school
, • B) Coordinating with the school to ensure the patient's educational and health needs are
met
• C) Recommending that the patient delay returning to school until treatment is
completed
• D) Informing the patient that they should not participate in physical education
Answer: B) Coordinating with the school to ensure the patient's educational and health needs
are met
Rationale: Health promotion and maintenance in the care continuum includes coordinating care
with the school to ensure the patient's educational and health needs are met .
Domain 2: Pediatric Hematology and Oncology Nursing Practice (18%)
5. A 6-year-old child is diagnosed with acute lymphoblastic leukemia (ALL). The nurse
understands that the most common presenting symptom of ALL is:
• A) Bone pain and fever
• B) Headache and vomiting
• C) Abdominal pain and constipation
• D) Skin rash and itching
Answer: A) Bone pain and fever
Rationale: Common presenting symptoms of ALL in children include bone pain, fever, fatigue,
easy bruising, and pallor due to bone marrow infiltration with leukemic cells .
6. Which of the following is the most common type of childhood cancer?
• A) Neuroblastoma
• B) Wilms tumor
• C) Acute lymphoblastic leukemia (ALL)
• D) Osteosarcoma
Answer: C) Acute lymphoblastic leukemia (ALL)
Rationale: ALL is the most common malignancy in children, accounting for approximately 25%
of all childhood cancers. It is a cancer of the blood and bone marrow characterized by the
overproduction of immature lymphocytes .
, 7. A child is diagnosed with sickle cell disease. The nurse's understanding of the
pathophysiology of this disorder is based on which of the following?
• A) A deficiency of red blood cells due to chronic bleeding
• B) A genetic mutation causing abnormal hemoglobin S, leading to sickling of red blood
cells
• C) An autoimmune disorder causing destruction of red blood cells
• D) A lack of clotting factors
Answer: B) A genetic mutation causing abnormal hemoglobin S, leading to sickling of red
blood cells
Rationale: Sickle cell disease is a genetic disorder caused by a mutation in the hemoglobin beta
gene, leading to the production of abnormal hemoglobin S. This causes red blood cells to
become sickle-shaped, leading to vaso-occlusion and hemolysis .
8. A nurse is reviewing the results of a bone marrow aspiration for a patient with leukemia.
The presence of which of the following would confirm the diagnosis?
• A) Decreased red blood cell count
• B) Presence of blasts (>20%)
• C) Elevated platelet count
• D) Increased mature lymphocytes
Answer: B) Presence of blasts (>20%)
Rationale: A bone marrow aspiration showing >20% blasts confirms the diagnosis of leukemia.
Other findings such as anemia and thrombocytopenia may be present but are not diagnostic on
their own .
9. A 3-year-old child is diagnosed with Wilms tumor. The nurse understands that the classic
presentation of this tumor includes:
• A) An abdominal mass that is often asymptomatic
• B) Severe headache and vomiting
• C) Bone pain and limping
• D) Unexplained fever and night sweats
